It is important to see your Dentist regularly so that we can keep you dentally fit. Guidelines recommend seeing your Dentist every 6 months.

As part of your routine dental examination the first and most important check that your are provided with is an oral screening of your soft tissues. Regular dental check-ups are therefore important as oral manifestations can be early warning signs of other more critical dental or clinical problems.

The dentist will examine the entire mouth for evidence of dental decay and gum disease.

The practice incorporates the use of digital x-rays, which are of a much lower dosage of radiation than conventional x-rays. In addition, the images are instantly available to assist with diagnosis and planning of treatment. Images can be viewed by patients on the computer screens when they are explained.

Our dentists will also advise on maintaining good oral health and on the impact of a range of influences such as lifestyle and diet on oral health and hygiene. We will if required recommend the use of a specialist hygienist.

When a tooth has dental decay, the decay is removed and the cavity is filled with a restoration that comes in the form of either amalgam or composite resin. Prior to insertion of the filling, a lining is often placed on the cavity floor. This acts as a thermal insulator for the nerve of the tooth and also helps prevent irritation of the nerve.

Amalgam and composite are materials that can be inserted directly into the tooth immediately following cavity preparation.

Amalgam filling

Composite 'white' filling

Amalgam becomes fully hard after 24 hours so care is needed when eating after an amalgam filling has been placed. Amalgam is silver in appearance.

Composite sets using a blue light. Once the blue light has been used, the composite is set and can be used for eating immediately. Composite is a tooth colored restoration and has very good aesthetic qualities. This will often be referred to as a 'White' filling.

Dental crowns are fitted onto the surface of broken or damaged tooth to rebuild their structure and function as well as restoring and improving appearance..

The process of making a crown begins with first preparing the tooth, usually by trimming it down in size. An impression is then taken which is sent to a laboratory to create the crown. Whilst the crown is being made, a temporary crown is fitted to the tooth.

Before After

There are various types of crowns using different materials and techniques and vary in cost and appearance. We will discuss the most suitable materials and variance in costs with the patient to ensure an excellent result.

A denture is a removable appliance for the replacement of missing teeth.

A partial denture is a denture that fills in the spaces left by lost or missing teeth in the upper or lower arch.

A complete denture replaces all of them in the upper or lower arch.

There are various types of dentures using different materials and techniques and vary in cost and appearance. We will discuss the most suitable materials and variance in costs with the patient to ensure an excellent, natural and comfortable result.

The process of making either type of denture is the same. This usually consists of a consultation and taking of the impression, a ‘try-in’ stage where you can inspect the appearance and fit of the denture prior to completion and the final stage where the finished product is fitted.

It is extremely important to realise that with an immediate denture the gums and bone will shrink under the denture as the sockets heal. This will continue over a 6 month period. During the 6 month healing phase it may be necessary to have the denture relined or adjusted. At the end of this period it may be necessary to have a new denture if the change in the mouth has been dramatic.

In some cases it may make more sense to remove the teeth, wait 6 months for healing to occur and then make a new denture in a mouth that is then stable. The main advantage of this is that, as a patient, you are not paying for two dentures.

One alternative for the replacement of missing teeth is a bridge. A bridge is a non-removable restoration usually cemented on either side of the missing tooth. It is important that the teeth to be used as anchors are both healthy and strong. This provides a secure platform, restoring both function and cosmetic appearance. A bridge can either be gold, porcelain bonded to gold or fully ceramic.

There are various types of crowns using different materials and techniques and vary in cost and appearance. We will discuss the most suitable materials and variance in costs with the patient to ensure an excellent result.

As there are various techniques and materials we will work closely with the patient and laboratory at every stage of the process to ensure an excellent, comfortable and natural looking result.

Prosthodontists are dentists that have specialised in planning, rehabilitation and maintenance of the oral dentition.

They are experts in providing the best dental aesthetic and functional result tailored to the specific requirements of the patient’s mouth. Our specialist prosthodontist, Assif Ahmed, utilises the best materials and liaises closely with the patient and dental laboratory at every stage of the process to ensure an excellent cosmetic and functional result.

Veneers are porcelain facings that are attached to the front of tooth to improve the cosmetic appearance. The preparation stage involves removing a very small amount of enamel from the front surface of the tooth. An impression is made, from which the laboratory then constructs the veneers which is then cemented to the front surface of the tooth. Veneers not only improve the aesthetic look of your tooth, but only it helps the tooth from being damaged. Many people opt for veneers to protect tooth’s surface from damage.

Dental Implants are an option for the replacement of irreparably damaged or missing teeth. The procedure involves the placement of titanium anchors into the jawbone. The bone then heals around the anchors. Once this occurs it is then strong enough to support a false tooth.

We will make an initial assessment as to whether the patient is suitable for the placement of a dental implant, based on general medical factors and the presence of enough bone to support the dental implant. Where there is not enough bone, a bone graft can sometimes assist with this problem.

Our specialist prosthodontists have been placing dental implants for our patients and for patients referred to us from other practices for many years. They are without question outstanding surgeons.

If implants are required as part of a periodontal treatment plan, then these will be installed by our periodontist Navidah Chaudhary whom is a specialist clinical lecturer in periodontics and periodontal surgery at Guy’s Hospital, Kings College London.

When you have your check up, they will measure your gum health using a device called a periodontal probe and it is used to measure, in millimetres, the tissue pockets around your teeth for loss of attachment and bone loss. If the probing depths are too deep to keep clean or if the dentist determines that your gums or bone levels are in jeopardy, they will refer you to a periodontist.

Periodontics is the dentistry in which the specialist takes care about the supporting structure of the teeth. A periodontist is one of the nine specialties recognized by the General Dental Council. From the Greek word “peri” meaning “around” and odons signifying “tooth,” a periodontist deals with the gums and supporting structures. A periodontist can be seen in conjunction with your regular dentist for the treatment and maintenance of gum disease.

A periodontist has many options to restore health. Typically, the initial process may include a non-surgical method of scaling and root planning. Plaque, tartar, rough cementum and diseased tissue is removed from the surrounding tooth and root surface. This method is called NSPT (Non-Surgical Periodontal Therapy) in which the bacterial viruses are eradicated to promote healthy re-growth.

Early signs are often soreness/bleeding from the gums when brushing or flossing. Other common signs can be exposure of the roots (gum recession) or drifting of the teeth.

Periodontitis is caused by a build-up of bacteria (dental plaque). Other factors such as smoking, family history, diabetes and stress have a significant impact on how susceptible you are to the disease. It is now understood that untreated periodontal disease can have effects on general health including diabetes, heart disease and pregnancy outcomes

If the disease is in an advanced stage, periodontal surgery can be employed. Some commonly prescribed surgeries include: pocket reduction (also known as gingival flap surgery), regeneration, crown lengthening, bone graft or soft tissue graft. In these procedures your periodontist will either fold back your gums to remove infection-causing bacteria, eliminate an overgrowth of gum tissue, replace lost bone or cut off tissue from elsewhere in your mouth and attach it to your gum line.

If left untreated periodontitis ultimately leads to the loosening or tooth loss as the supporting bone is destroyed. Periodontitis is the leading cause of tooth loss.

With careful assessment, it is normally possible to halt the progress of periodontitis. Treatment requires oral hygiene instruction and advice on home care followed by professional cleaning under local anaesthetic by the periodontist and/or a hygienist.

Following the initial treatment, patients are then reassessed after a few weeks to ensure the disease has resolved. If localised areas of periodontitis are found to persist, these isolated areas may require further care, which may include surgical corrective therapy.

Long-term success of periodontal treatment depends on both your own efforts with oral hygiene and those of the practice team who provide your regular care.

Regular follow-up appointments with your hygienist and periodontist are vitally important to ensure the disease process does not reoccur.

X-Rays showing the loss of bone through gum disease

Please click here to learn more about our periodontist, Robert Ward and also our specialist hygienist Simone Cowan.

Endodontics is the treatment of a root canal that is primarily performed on teeth that have died or have an infection as a result of either trauma or dental decay. This involves removal of the dead nerve and blood supply tissue within the root canals of the tooth, disinfection of the root canals so that no bacteria are left behind and then finally filling and sealing of the root canals.

The specialist endodontist uses a dental microscope for root canal treatment, which is especially important so that the endodontist has a complete view of the inside of the tooth.

One of the prerequisites for success of the root canals to be filled exactly to the end, ideally achieved with an apex locator, which allows the endodontist to work in all three dimensions.

Infected root canal After treatment

At Handside Dental Surgery dental rubber dam is used routinely for all root canal treatments to isolate the tooth and help prevent bacteria contaminating the root canals during process.

We use all the latest equipment including a Global G4 dental microscope and techniques to provide you with the best possible preparation, disinfection and filling of the root canals.

Please click here to learn more about our specialist endodontist Alessandro Falanga whom as well as a specialist endodontist is also a clinical teacher at King’s College London.

This is the process of gradually whitening teeth over a period of time to create a healthier-looking whiter smile.

Tooth whitening gel is put into the bleaching tray which is worn by the patient for 14 nights.

We now offer the world’s best professional teeth whitening system and the ONLY one to guarantee shade B1 - by Enlighten Smiles www.enlightensmiles.com.

This system involves three appointments at the clinic. Firstly there is an initial consultation and taking of impressions of the upper and lower teeth for making the tailor made bleaching trays which are constructed at a laboratory for optimum fit. A second appointment is then organised to fit the trays. At this stage the patient takes home the tooth whitening gel to begin the whitening process. Finally, two weeks later, there is a follow up appointment where 2 20 minute applications of accelerated whitening gel are applied in the surgery under the direction and watchful eye of the dentist.

Although alternative techniques are utilised elsewhere, including ‘laser’ treatment, all the dental journals confirm, this method of a combination of home-whitening and in surgery whitening ensures the best long term result. Contact us now for teeth whitening treatments.

Dental hygiene therapy is utilised to help both treat and prevent gingivitis and periodontitis.

Gingivitis is inflammation of the gums only. Periodontitis (gum disease) is the destruction of the tissues that support the tooth, i.e. gums and bone. The continued progress of periodontitis leads to the eventual total loss of support of the tooth followed by loss of the tooth itself (see Periodontics). As the disease progresses, the gums begin to separate from the teeth to form pockets, allowing the continued downward acceleration of plaque below the gum line.

Periodontitis and gingivitis are both caused by the build-up of plaque and calculus (scale) on the teeth. We help patients to treat gum disease and maintain healthy gums through careful help from both the dentist and dental hygienist. Periodontist depending on its severity assesses the extent of the problem and monitors its progress, whilst patients are referred to the dental hygienist who specialises in removing the deposits on the tooth and providing detailed oral hygiene instruction to help prevent further accumulation.

Once the problem in gums has been eradicated it is also important to prevent its return. Patients are therefore encouraged to visit the dental hygienist routinely for maintenance of good gum condition.

A good tooth brush and cleaning between the teeth are imperative for good dental hygiene and our hygienists will provide education and instruction in these. Handside Dental Surgery believe in the use of TePe products.

There are many ways of cleaning between the teeth. What cleaning device you choose depends on the sizes of the gaps, but also on your own preferences. TePe offers several alternatives for your daily interdental cleaning.

Handside Dental Surgery now has five hygienists Simone Cowan, Angela Tierney, Diane Bailey, Angela Coleman and Julie Dunham covering every day of the week excluding Sundays and offering a mix of 20 and 30 minute appointments depending on your clinical requirements.

Recent changes to the law now enable patients to access a dental hygienist without a referral from their dentist.

The changes, which came into play on the 1st May 2013 enable patients easier access to dental hygiene services, which will help reduce gum disease. Previously, patients had to be referred by their dentist to see a dental hygienist.

Patients have had to see their dentist before being able to book an appointment with a dental hygienist since 1945 and the change marks a major step forward, especially as the The British Society of Dental Hygiene and Therapy has been campaigning for new legislation for the last two decades.

The new laws give patients better access to preventative dental treatment and advice about oral health issues, such as lifestyle choices, diet and oral hygiene.

A sinus lift is surgery that adds bone to your upper jaw in the area of your molars and premolars. It's sometimes called a sinus augmentation. The bone is added between your jaw and the maxillary sinuses, which are on either side of your nose. To make room for the bone, the sinus membrane has to be moved upward, or "lifted." A sinus lift usually is done by a specialist. This could be either an oral and maxillofacial surgeon or a periodontist.

What It's Used For

A sinus lift is done when there is not enough bone height in the upper jaw, or the sinuses are too close to the jaw. There are several reasons for this:

Many people who have lost teeth in their upper jaw - particularly the back side, or molars - do not have enough bone left. Because of the anatomy of the skull, the back of the upper jaw has less bone than the lower jaw.

Bone may have been lost because of periodontal (gum) disease.

Tooth loss may have led to a loss of bone as well. Once teeth are gone, bone begins to be resorbed (absorbed back into the body). If they have been missing for a long time, there often is not enough bone left to place implants.

The maxillary sinus may be too close to the upper jaw for implants to be placed. The shape and the size of this sinus varies from person to person. The sinus also can get larger as you age.

Sinus lifts have become common during the last 15 years as more people get dental implants to replace missing teeth.

Sinus lifts have become common during the last 15 years as more people get dental implants to replace missing teeth.

Preparation

The bone used in a sinus lift may come from your own body (autogenous bone), from a cadaver (allogeneic bone) or from cow bone (xenograft).

If your own bone will be used in the sinus lift, it will be taken from other areas of your mouth or body. In some cases, the surgeon removes bone from your hip or tibia (the bone beneath the knee).

You will need X-rays taken before your sinus lift so the dentist can study the anatomy of your jaw and sinus. You also may need a special type of computed tomography (CT) scan. This scan will allow the dentist to accurately measure the height and width of your existing bone and to evaluate the health of your sinus.

If you have seasonal allergies, you should schedule the procedure when they are not active.

How It's Done

Your surgeon will cut the gum tissue where your back teeth used to be. The tissue is raised, exposing the bone. A small, oval window is opened in the bone. The membrane lining the sinus on the other side of the window separates your sinus from your jaw. This membrane is gently pushed up and away from your jaw.

Granules of bone-graft material are then packed into the space where the sinus was. The amount of bone used will vary, but usually several millimetres of bone is added above the jaw.

Once the bone is in place, the tissue is closed with stitches. Your implants will be placed four to nine months later. This allows time for the grafted material to mesh with your bone. The amount of time depends on the amount of bone needed.

Follow-Up

After the procedure, you may have some swelling of the area. You may bleed from your mouth or nose. Do not blow your nose or sneeze forcefully. Either one could cause the bone-graft material to move, and loosen the stitches.

Your dentist may give you saline sprays to keep the inner lining of your nose wet and prescribe medicine to prevent congestion and inflammation. You also will be given pain medicine, an antibiotic and an antimicrobial mouthwash to help prevent infection. Most patients have only a little discomfort after a sinus-lift procedure.

You will see the specialist after 7 to 10 days. He or she will evaluate the surgical site and remove stitches if they will not dissolve on their own. You might be asked to return a few more times to make sure the area is healing properly.

After a sinus lift, you need to wait several months for the bony material to harden and integrate with your jaw. Depending on the grafting material used, implants may be placed in four to nine months.

Some specialists have started using proteins called growth factors to help the new bone harden faster. Platelet-rich plasma, which contains the growth factors, is taken from your blood before surgery and mixed with the graft that is placed into your sinus. Human-recombinant bone morphogenetic protein is an engineered protein that is now available. It stimulates bone formation without grafting.

Risks

The main risk of a sinus lift is that the sinus membrane could be punctured or torn. If the membrane is torn during the procedure, the surgeon will either stitch the sinus tear or place a patch over it. If the repair is not successful, your surgeon may stop the procedure and give the hole time to heal.

Your dentist can redo the sinus lift once the membrane has healed. This usually takes a few months. A healed membrane tends to be thicker and stronger, which means a second attempt at a sinus lift is likely to be successful. However, other factors also affect success.

Infection is a risk of any surgical procedure. However, this rarely occurs after sinus lifts.

On rare occasions, the existing bone does not integrate with the bony graft material, and the grafted area does not develop a blood supply. If this happens, any implants placed in this area will fail because there is no live bone for them to attach to. If this happens, you can have the sinus lift procedure repeated.

When To Call a Professional

After a sinus lift, contact your surgeon if:

Any swelling or pain gets worse over time. (It should decrease after the first two days or so.)

The bleeding does not stop after one to two days.

Bleeding is bright red and continuous. (Normal bleeding after this procedure oozes slowly and is dark red with possible clots.)

You think the bony material may have been dislodged after sneezing or blowing your nose.

Denplan is the UK’s leading dental payment plan specialist. Having either a Denplan Care or Essentials membership plan with Handside Dental Surgery will help you to budget for your preventive dental care and to maintain or improve your oral health.

Keeping dentally fit really isn’t that difficult or expensive and it can make a huge difference to how you feel about yourself!

Denplan Care gives you:

Two dental check-ups per year including dental x-rays

Two hygienist visit per year

Any necessary fillings

Other dental treatment as agreed with his dentist

Denplan Essentials gives you:

Two dental check-ups per year

Two hygienist visit per year

Discounts on dental treatment

The monthly fee for both plans are set by your dentist and are based on the level of your oral health. Denplan Care also includes mandatory Supplementary Insurance. This provides you with cover towards the cost of eligible dental treatment received as a result of a dental injury or dental emergency. Supplementary Insurance also gives you access to the 24-Hour Worldwide Dental Emergency Helpline to assist you anywhere in the world at any time.

At handside, we also offer emergency dentist services. If you need an emergency dentist, please feel free to call us and we will arrange the appointment as soon as we can.

For more information please contact Catherine Good or click here to visit the Denplan Website.

Residents of Hertfordshire can contact us to book an appointment. Our surgery is located in Welwyn Garden City, Hertfordshire.

Fee Guide

It is our practice policy to give our patients full information about the cost of their dental work before any treatment is undertaken. A written estimate and personalised treatment plan will be provided if requested. Private Fees vary depending on the treatment being requested and its complexity and specialisation and therefore prices should be discussed when seeing the dentist or consultant.

We offer patients a range of treatment options depending on needs. You may pay for your dental care by cash or credit/debit card. Unfortunately cheques are no longer accepted. For certain treatments and amounts finance options are available dependent on patient circumstances.

NHS Dentistry

NHS treatment is offered to all NHS registered patients and all children under 18 years are treated free of charge.

The practice operates a strict practice polciy that inorder to maintain their entitlement to NHS treatment patients have to attend for a check up at least every 2 years and that they must not fail to attend booked appointments twice

Testimonial

“I would very much like to thank you, for the new lease of life I have been given since your treatment.

You managed to give me back my smile and confidence. I am now 68 and feel younger than I did 30 years ago when I first started to suffer with my teeth.”